| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,551 |
1,551 |
$161K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
731 |
731 |
$92K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,587 |
1,577 |
$48K |
| 92015 |
Determination of refractive state |
2,665 |
2,664 |
$47K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
950 |
943 |
$23K |
| V2020 |
Frames, purchases |
1,703 |
1,694 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
25 |
25 |
$558.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,603 |
1,593 |
$0.00 |